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Soil-transmitted helminth (STH) (A. lumbricoides, T. trichiura and hookworm) infections are a significant public health concern in Honduras. These infections are treatable using inexpensive anthelmintic medications, however long-term control and eradication will require large investments in public and private sanitation infrastructure. Importantly, both types of interventions are targeted towards high-risk populations and regions rather than individuals. The goal of this thesis is to contribute to improving the efficiency of soil-transmitted helminth control efforts in Honduras. In our first study, we use multiple regression analyses to identify determinants of STH infections and generate estimates of A. lumbricoides, T. trichiura and hookworm infection prevalence, as well as recommended deworming frequencies, for each of Honduras’ 298 municipalities. Our estimates suggest that prevalence of all three infections has declined over time, however 75% of municipalities still require annual or semi-annual deworming. In our second study, we quantify how the type of region used for measuring prevalence and allocating resources can impact the success and efficiency of public health programs. More specifically, we compare administrative regions to alternative zoning schemes at the same geographic scale. Our findings suggest that regions designed to be homogeneous with respect to prevalence can be more efficient than existing municipalities (at the same scale) for distributing resources. This research has implications on future control efforts. / Thesis / Master of Science (MSc)

The purpose of this study was to determine the prevalence of known risk factors associated with diabetes among James Moody Adams (JMA) clinic patients in order to develop and test educational material and clinical interventions to reduce the incidence of pre-diabetes and uncontrolled Type II Diabetes. The research objectives for this study focused on: 1. prevalence of Type II Diabetic patients at the Clinic; 2. pre- and post-test knowledge level of patients regarding their Type II Diabetes; 3. relationship between dependent variables (body mass index [BMI], blood glucose level, blood pressure, waist circumference, level of tobacco use, and level of depression) and the independent variables (age, gender, family history of diabetes, socio-demographical data [education level, level of income], literacy, and exercise regimen, medication, and diabetes knowledge); 4. effectiveness of a nutritional and lifestyle modification intervention program to control Type II Diabetes. Two hypotheses tests: 1. decrease blood glucose levels of Type II Diabetes Mellitus patients; 2. decrease weight by 5 percent among pre-diabetic and Type II Diabetes Mellitus patients. A follow-up survey determined participant's reflection on key dimensions of the study and impact of unforeseen political unrest that occurred during this study. The methodology was a case study with clinical and educational intervention across a 6 months. The population included patients presenting at the JMA clinic at onset of the study; an initial sample of 96 reduced to 48 due in part to political unrest was still within power test specification. Instrumentation include researcher developed, standard of care clinical practice and standardized forms. Analyses utilized descriptive statistics and t-test. Significant gain was determined for diabetic knowledge (p < 0.001); and significant decrease in Type II Diabetic blood glucose with p = 0.031. An important conclusion is that implementing a Type II Diabetic prevention program is feasible and effective in this study. Future recommendations include replication of the study and implementation of protocols and education that were successful in this study. / Ph. D.

The two papers in this thesis are aimed at solving problems in Integrated Pest Management project, practice, and program evaluations. In the first paper, an evaluation design is constructed for the Onion ipmPIPE website, an onion pest information website. The Bayesian decision theoretic approach may not accurately model onion growers' pest management decisions throughout the season. Randomization of the treatment is possible, but an incomplete grower list proved to be a problem. The analysis shows that an instrumental variables approach may be the most appropriate method for estimating the impact of the Onion ipmPIPE website because its data needs are solved by using USDA-NASS surveying services. In the second paper, the challenge is to develop a practical method to measure benefits accruing to women from agricultural research using secondary data. Donors, governments and others are interested in determining how benefits from agricultural research accrue to women. We develop a three-step framework to identify women's crops and technologies. In step one, total potential benefits from research are estimated; step two allocates those benefits between men and women; step three, incorporates technology-specific parameters to refine the estimates of potential benefits. We apply this framework to Honduras and find that steps one and two provide the most information on the magnitude and distribution of benefits, but that refinements in step three can affect rankings of research program impacts on women. / Master of Science

Smallholder farmers in Honduras and the Trifinio region of Central America contend with poor roads and high transportation costs when making production decisions. Farmers select crop activities based on cost, revenue and profit but are constrained by labor requirements, cash requirements, food security concerns, and input and output market access. Market access is directly related to distance to market. Distance to market increases the cost of inputs, increases transportation costs, and reduces the effective price farmers receive for outputs. We conduct two analyses to study the impact of distance to market on crop and technology choices. We utilize a household survey to analyze the determinants of fruit and vegetable production and market participation. Probit and multinomial logit models are employed to analyze the impact of distance to market and other variables on fruit and vegetable production. Results indicate that as distance to market increases, the probability of fruit and vegetable production for consumption increases and the probability of fruit and vegetable production for sale at market decreases. In a second paper, we utilize data from extension agencies, research institutions, a household survey, and expert opinions to model a representative Honduran farm. With linear programming, we analyze the crop and technology mix selected by the farm given changes in distance to the output market, changes in distance to the input market, food security concerns, and labor market participation. We focus specifically on integrated pest management (IPM) technologies. Results indicate that beyond a specific distance, vegetable production ceases, while staple crop production remains profitable. Additionally, a combination of low, medium, and high-technology crop activities is selected by a profit-maximizing farm. Even far away from the market, medium and high-technology crop activities are selected. Overall, these two studies indicate that distance to market is negatively related to fruit and vegetable production. A reduction in transportation costs and an increase in the prevalence of less input-intensive integrated pest management techniques may increase the incidence of fruit and vegetable production and market participation in Trifinio and Honduras. / Master of Science

Nas Américas, em especial na América do Sul, a infecção por Leishmania (L.) infantum chagasi causa manifestações subclínicas e leishmaniose visceral (LV), a qual quando não tratada é potencialmente fatal. Na América Central, especialmente em Honduras, a leishmaniose cutânea não ulcerada ou atípica e a leishmaniose visceral são causadas pelo mesmo agente etiológico Leishmania (L.) infantum chagasi e ocorrem na mesma região geográfica. Pouco se conhece sobre o perfil da infecção humana por Leishmania (L.) infantum chagasi em Honduras, especialmente sobre a forma não ulcerada ou atípica, sendo assim, no sentido de compreender melhor a patogênese da infecção causada por esta espécie de parasito no município de Amapala (Valle) e Orocuina (Choluteca), Honduras, o presente estudo visou a caracterização histopatológica e da resposta imune celular in situ em lesões de pacientes com leishmaniose cutânea não ulcerada ou atípica. Foram utilizadas 20 biópsias de pele de pacientes com diagnóstico parasitológico confirmado por raspado de lesão corado por Giemsa e observado em microscópio ótico. A histopatologia foi avaliada em cortes histológicos corados por hematoxilina-eosina (HE) e a resposta imune por meio da reação de imunoistoquímica utilizando anticorpos primários para macrófagos (CD68), linfócitos T (CD4, CD8), células natural killer - NK (CD56), linfócitos B (CD20), óxido nítrico sintetase (NOS2) e interferon-gama (IFN-y. Microscopicamente as alterações histopatológicas mais significativas foram observadas na derme superficial e profunda caracterizando-se por um infiltrado inflamatório predominantemente linfohistiocitário de intensidades variável com arranjo difuso e, por vezes, associado à formação de granulomas epitelioides. A observação de formas sugestivas do parasito ocorreu em apenas 55 % dos casos. A análise imunoistoquímica das lesões confirmou a presença de células mononucleares no infiltrado inflamatório caracterizada principalmente pela presença de linfócitos TCD8+, seguido por TCD4+, macrófagos, linfócitos B e células NK. A grande densidade de células INF-y+ e a presença da enzima iNOS, responsável pela produção de óxido nítrico, molécula com atividade leishmanicida, em quase a totalidade dos macrófagos do infiltrado inflamatório, sugere uma resposta imune local bastante efetiva, que colabora para o controle do número de parasitos e consequentemente a evolução do tamanho da lesão / In America, especially in South America, infection by Leishmania (L.) infantum chagasi causes subclinical manifestations and visceral leishmaniasis (VL), which when untreated is potentially fatal. In Central America, especially in Honduras, non-ulcerated or atypical cutaneous leishmaniasis and visceral leishmaniasis are caused by the same etiologic agent Leishmania (L.) infantum chagasi and occur in the same geographic region. Little is known about the profile of human infection by Leishmania (L.) infantum chagasi in Honduras, especially on the non-ulcerated or atypical form. In order to better understand the pathogenesis of the infection caused by this species of parasite in the municipality of Amapala (Valle) and Orocuina (Choluteca), Honduras, the present study aim the characterization of histopathological changes and cellular immune response in situ in lesions of patients with non-ulcerated or atypical cutaneous leishmaniasis. Twenty skin biopsies from patients with parasitological diagnosis confirmed by scraping of Giemsa-stained lesion and observed using an optical microscope. Histopathology, was evaluated by hematoxylin-eosin (HE) and the immunohistochemistry using the primary antibodies to macrophages (CD68), T lymphocytes (CD4, CD8), natural killer cells - NK (CD56), B lymphocytes CD20), nitric oxide synthase (NOS2) and interferon-gamma (IFN-y). Microscopically, the most significant histopathological changes were observed in the superficial and deep dermis, characterized by a predominantly lymphohistiocytic inflammatory infiltrate of variable intensities with diffuse arrangement and sometimes associated with the formation of epithelioid granulomas; the observation of suggestive forms of the parasite occurred in only 55 % of the cases. The immunohistochemical analysis of the lesions confirmed the presence of mononuclear cells in the inflammatory infiltrate characterized mainly by the presence of T-CD8+ lymphocytes, followed by T-CD4+, macrophages, B lymphocytes and NK cells. The high density of INF-y+ cells and the presence of iNOS, enzyme responsible for the production of nitric oxide, molecule with activity leishmanicide, in almost all of the macrophages in the inflammatory infiltrate, suggest an effective local immune response that collaborate to the control in the number of parasites and consequently the evolution of the lesion

Nas Américas, em especial na América do Sul, a infecção por Leishmania (L.) infantum chagasi causa manifestações subclínicas e leishmaniose visceral (LV), a qual quando não tratada é potencialmente fatal. Na América Central, especialmente em Honduras, a leishmaniose cutânea não ulcerada ou atípica e a leishmaniose visceral são causadas pelo mesmo agente etiológico Leishmania (L.) infantum chagasi e ocorrem na mesma região geográfica. Pouco se conhece sobre o perfil da infecção humana por Leishmania (L.) infantum chagasi em Honduras, especialmente sobre a forma não ulcerada ou atípica, sendo assim, no sentido de compreender melhor a patogênese da infecção causada por esta espécie de parasito no município de Amapala (Valle) e Orocuina (Choluteca), Honduras, o presente estudo visou a caracterização histopatológica e da resposta imune celular in situ em lesões de pacientes com leishmaniose cutânea não ulcerada ou atípica. Foram utilizadas 20 biópsias de pele de pacientes com diagnóstico parasitológico confirmado por raspado de lesão corado por Giemsa e observado em microscópio ótico. A histopatologia foi avaliada em cortes histológicos corados por hematoxilina-eosina (HE) e a resposta imune por meio da reação de imunoistoquímica utilizando anticorpos primários para macrófagos (CD68), linfócitos T (CD4, CD8), células natural killer - NK (CD56), linfócitos B (CD20), óxido nítrico sintetase (NOS2) e interferon-gama (IFN-y. Microscopicamente as alterações histopatológicas mais significativas foram observadas na derme superficial e profunda caracterizando-se por um infiltrado inflamatório predominantemente linfohistiocitário de intensidades variável com arranjo difuso e, por vezes, associado à formação de granulomas epitelioides. A observação de formas sugestivas do parasito ocorreu em apenas 55 % dos casos. A análise imunoistoquímica das lesões confirmou a presença de células mononucleares no infiltrado inflamatório caracterizada principalmente pela presença de linfócitos TCD8+, seguido por TCD4+, macrófagos, linfócitos B e células NK. A grande densidade de células INF-y+ e a presença da enzima iNOS, responsável pela produção de óxido nítrico, molécula com atividade leishmanicida, em quase a totalidade dos macrófagos do infiltrado inflamatório, sugere uma resposta imune local bastante efetiva, que colabora para o controle do número de parasitos e consequentemente a evolução do tamanho da lesão / In America, especially in South America, infection by Leishmania (L.) infantum chagasi causes subclinical manifestations and visceral leishmaniasis (VL), which when untreated is potentially fatal. In Central America, especially in Honduras, non-ulcerated or atypical cutaneous leishmaniasis and visceral leishmaniasis are caused by the same etiologic agent Leishmania (L.) infantum chagasi and occur in the same geographic region. Little is known about the profile of human infection by Leishmania (L.) infantum chagasi in Honduras, especially on the non-ulcerated or atypical form. In order to better understand the pathogenesis of the infection caused by this species of parasite in the municipality of Amapala (Valle) and Orocuina (Choluteca), Honduras, the present study aim the characterization of histopathological changes and cellular immune response in situ in lesions of patients with non-ulcerated or atypical cutaneous leishmaniasis. Twenty skin biopsies from patients with parasitological diagnosis confirmed by scraping of Giemsa-stained lesion and observed using an optical microscope. Histopathology, was evaluated by hematoxylin-eosin (HE) and the immunohistochemistry using the primary antibodies to macrophages (CD68), T lymphocytes (CD4, CD8), natural killer cells - NK (CD56), B lymphocytes CD20), nitric oxide synthase (NOS2) and interferon-gamma (IFN-y). Microscopically, the most significant histopathological changes were observed in the superficial and deep dermis, characterized by a predominantly lymphohistiocytic inflammatory infiltrate of variable intensities with diffuse arrangement and sometimes associated with the formation of epithelioid granulomas; the observation of suggestive forms of the parasite occurred in only 55 % of the cases. The immunohistochemical analysis of the lesions confirmed the presence of mononuclear cells in the inflammatory infiltrate characterized mainly by the presence of T-CD8+ lymphocytes, followed by T-CD4+, macrophages, B lymphocytes and NK cells. The high density of INF-y+ cells and the presence of iNOS, enzyme responsible for the production of nitric oxide, molecule with activity leishmanicide, in almost all of the macrophages in the inflammatory infiltrate, suggest an effective local immune response that collaborate to the control in the number of parasites and consequently the evolution of the lesion

El presente informe de suficiencia profesional se enfoca en el fallo emitido por la Corte Interamericana de Derechos Humanos en el caso Vicky Hernández y otras vs. Honduras. La cuestión principal se centra en determinar la responsabilidad del Estado de Honduras ante el sistema interamericano por la falta de juzgamiento y el fallecimiento de Vicky Hernández debido a su condición de mujer trans. El enfoque metodológico se basa en la aplicación de instrumentos internacionales, incluyendo la Convención de Belém do Pará, la Convención sobre la Eliminación de Todas las Formas de Discriminación contra la Mujer, la Convención Internacional sobre la Eliminación de todas las Formas de Discriminación e Intolerancia y la Convención Americana de Derechos Humanos. Asimismo, se analiza la jurisprudencia de la Corte Interamericana de Derechos Humanos en casos relevantes, como Atala Riffo y Niñas vs. Chile, Flor Freire vs. Ecuador, Duque vs. Colombia y Azul Rojas Marín y otra vs. Perú. Además, se considera la doctrina pertinente que aborda los derechos vulnerados en el presente caso. Como conclusión, se determina que el Estado de Honduras es responsable ante el sistema interamericano por la violación de los derechos a la igualdad y no discriminación, vida, integridad personal, garantias judiciales, protección judicial, reconocimiento de la personalidad jurídica, libertad de expresión, vida privada y nombre de Vicky Hernández en su condición de mujer trans, en virtud de los estereotipos y prejuicios existentes en relación a las trabajadoras sexuales trans. / This professional sufficiency report focuses on the ruling issued by the Inter-American Court of Human Rights in the case of Vicky Hernández et al. Honduras. The main issue focuses on determining the responsibility of the State of Honduras before the inter-American system for the lack of trial and the death of Vicky Hernández due to her status as a trans woman. The methodological approach is based on the application of international instruments, including the Convention of Belém do Pará, the Convention on the Elimination of All Forms of Discrimination against Women, the International Convention on the Elimination of all Forms of Discrimination and Intolerance and the American Convention on Human Rights. Likewise, the jurisprudence of the Inter-American Court of Human Rights in relevant cases, such as Atala Riffo and Girls vs. Chile, Flor Freire vs. Ecuador, Duke vs. Colombia and Azul Rojas Marín and another vs. Peru. In addition, the pertinent doctrine that addresses the rights violated in the present case is considered. In conclusion, it is determined that the State of Honduras is responsible before the inter-American system for the violation of the rights to equality and non-discrimination, life, personal integrity, judicial guarantees, judicial protection, recognition of legal personality, freedom of expression, private life and name of Vicky Hernández as a trans woman, due to existing stereotypes and prejudices in relation to trans sex workers.

The purpose of this thesis is to show that stable isotope analysis can be used to predict K’inich Yax K’uk Mo’s stable isotope measures based on Stuart’s (2007) hypothesis that K’inich Yax K’uk Mo’, the dynastic founder of the Copan royal lineage, was a Caracol lord. There is significant and convincing evidence that K’inich Yak K’uk Mo’ had a non-Copanec origin. Stable isotope analysis is a tested and reliable method for detailing diets and migratory paths of ancient humans and this theory is applied as a predictor of the stable isotope measures of K’inich Yax K’uk Mo’, if he did in fact originate in Caracol. The literature is rich with explanations of stable isotopes and the writings of a few stalwarts in the field were utilized to gain an understanding of the associated technologies and techniques utilized in its analysis. Data from the Copan (Whittington and Reed 1997) and Caracol (Chase and Chase 2001) stable isotope studies were utilized to show the application of stable isotope analysis in areas “associated” with K’inich Yax K’uk Mo’ and to illustrate how the palace diet identified by Chase and Chase (2001; Chase et al. 2001) could be aligned with the Stuart hypothesis to predict the stable isotope ranges for K’inich Yax K’uk Mo’.

En 2007, le premier ministre Stephen Harper a annoncé que le renouvellement de l’engagement du Canada dans les Amériques était une priorité internationale pour son gouvernement. Le document qui a formalisé la nouvelle priorité accordée à l’hémisphère occidental stipule que le Canada s’est engagé à faire progresser concurremment la démocratie, l’intégration économique et la sécurité. Cette recherche a pour but de remettre en cause le discours officiel en analysant la politique du Canada à l’égard de la Colombie et du Honduras. L’étude sur le cas colombien porte sur les effets de l’intégration économique sur les droits humains et la sécurité. Elle montre que le texte de l’accord de libre-échange Canada-Colombie et les évaluations d’impact sur les droits humains n’abordent pas convenablement les risques entourant les investissements canadiens et que leurs lacunes diluent l’engagement d’Ottawa envers la protection des droits humains et la résolution du conflit. L’étude sur le cas hondurien porte sur l’impact des déficits démocratiques et de l’insécurité sur l’intégration économique. Elle montre que le virage à droite qui a suivi le coup d’État de 2009 a permis au gouvernement canadien d’entreprendre des négociations de libre-échange bilatérales et de prendre part à la réforme du code minier du Honduras, tandis que les déficits démocratiques et l’insécurité ont empêché la population hondurienne de participer d’une manière significative au processus d’intégration économique. Nous concluons que ces deux cas contredisent le discours officiel dans la mesure où l’objectif de l’intégration économique a été atteint aux dépens des autres objectifs. / In 2007, Prime Minister Stephen Harper announced that the renewal of Canada’s engagement in the Americas was an international priority for his government. The document that formalized the new emphasis on the western hemisphere stipulates that Canada is committed to advancing democracy, economic integration, and security simultaneously. The purpose of this research is to challenge the official discourse by examining Canada’s policy towards Colombia and Honduras. The Colombia case study focuses on the effects of economic integration on human rights and security. It argues that the text of the Canada-Colombia free trade agreement and the human rights impact assessments do not adequately address the risks posed by Canadian investments and that their shortcomings dilute Ottawa’s commitment to human rights protection and conflict resolution. The Honduras case study is concerned with the impact of democratic deficits and insecurity on economic integration. It shows that the rightward shift that followed the 2009 coup d’État allowed the Canadian government to undertake bilateral free trade negotiations and take part in the reform of the Honduran mining code while democratic deficits and insecurity prevented the meaningful participation of the Honduran people in the economic integration process. I conclude that these two cases contradict the official discourse, as the goal of economic integration has been reached at the expense of the other objectives.